ArticleAnaesthesia2026
Time of day of cardiac surgery and postoperative outcomes in the UK: a secondary analysis of linked national datasets.
Article in Anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- Regulation of ultradian pulsatility and stress responses in the human hypothalamic-pituitary-adrenal axis.Journal of neuroendocrinology · 2026Article
- Time of day of cardiac surgery and postoperative outcomes: a reply.Anaesthesia · 2026Article
- Time of day of cardiac surgery and postoperative outcomes: exploratory findings require caution.Anaesthesia · 2026Article
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Authors and funding
12 authors.
Funding
Abstract
introductionUncertainty remains regarding whether the time of day that cardiac surgery is performed affects postoperative outcomes or if the observed variation can be explained by patient or surgical factors.
methodsA secondary analysis of prospectively collected data was conducted to examine the association between time of cardiac surgery and clinical outcomes. Data were derived from four linked UK datasets: the National Adult Cardiac Surgery Audit; the Case Mix Programme; Hospital Episode Statistics; and Office for National Statistics mortality records. The primary outcomes were hazard of death due to cardiovascular disease and time to hospital readmission for myocardial infarction or acute heart failure. Secondary outcomes included duration of postoperative hospital stay; occurrence of major cardiovascular events; and all-cause mortality.
resultsLinked data for 24,068 patients were identified. Surgeries performed in late morning (10:00 to 11:59) had the highest mean (SD) predicted risk of death (3.7% (4.6)), compared with 3.2% (3.7) for early morning (07:00 to 09:59), 2.8% (3.4) for early afternoon (12:00 to 13:59) and 3.1% (3.6) for late afternoon (14:00 to 19:59) surgeries, respectively. The primary outcome measures showed an increased hazard of death from cardiovascular disease in the late morning (adjusted hazard ratio 1.18, 95%CI 1.00-1.39), with no difference in hazard of readmission for myocardial infarction or acute heart failure (adjusted hazard ratio 0.97, 95%CI 0.85-1.11). There were no differences in the secondary outcome measures. DISCUSSION: Time-of-day variation in postoperative death due to cardiovascular disease following cardiac surgery was observed, with the highest risk seen in late morning procedures. These findings suggest that intra-operative or organisational factors specific to this period may influence outcomes. Future research should explore whether individual circadian phenotypes or chronotypes contribute to this variation, supporting a move towards precision and personalised scheduling of cardiac surgery to optimise patient outcomes.
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